Drug & supplement interaction

Quassia + Sacubitril, Valsartan

Sacubitril, Valsartan brand name: Entresto.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Quassia has a moderate interaction with Sacubitril, Valsartan. Overuse of quassia might compound diuretic-induced potassium loss.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Quassia and Sacubitril, Valsartan

Here is the interaction we found between these two, with the evidence behind it.

Moderate

DIURETIC DRUGS

Why this applies to Sacubitril, Valsartan

Sacubitril, Valsartan falls under DIURETIC DRUGS — the group Quassia interacts with.

Overuse of quassia might compound diuretic-induced potassium loss. There is some concern that people taking quassia along with potassium depleting diuretics might have an increased risk for hypokalemia. Initiation of potassium supplementation or an increase in potassium supplement dose may be necessary for some patients.
Some diuretics that can deplete potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), and hydrochlorothiazide (HCTZ, Hydrodiuril, Microzide), and others.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the wrinkle with Entresto (sacubitril/valsartan). The valsartan piece actually tends to raise potassium, not lower it, which is the opposite of the water pills mentioned in this interaction note. So the original concern, that quassia plus a potassium-wasting diuretic could drop your potassium too low, doesn't really line up with Entresto on its own.

This flag is also purely theoretical, based on how quassia might behave in the body rather than real-world reports. Bottom line: I wouldn't expect a meaningful clash here, and small culinary amounts of bitters are even less of a worry. Still, since Entresto can shift potassium and your kidneys, it's worth a quick chat with your pharmacist before adding concentrated quassia supplements.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Robbers JE, Speedie MK, Tyler VE. Pharmacognosy and Pharmacobiotechnology. Baltimore, MD: Williams & Wilkins, 1996.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Quassia Also Interacts With Other Medications

Quassia has 161 moderate, 36 minor known drug interactions in our database — the Sacubitril, Valsartan one above is one of them. If you take anything else, check it against the full list below.

Moderate 161 Minor 36 No known interaction 2,633 (incl. Sacubitril, Valsartan)
Taking anything else?

Check Another of Your Medications Against Quassia

Covers the 2,830 medications we’ve checked against Quassia. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Sacubitril, Valsartan

This page covers Quassia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sacubitril, Valsartan page lists 249 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Lithium (major) and Oleander (major).

By severity: 7 major · 206 moderate · 36 minor.

From our pharmacist’s overview on the Sacubitril, Valsartan page

“Entresto (sacubitril and valsartan) is a heart failure medicine, and heart failure patients tend to be heavy supplement users, reaching for fish oil, potassium, and herbal blood-pressure remedies. That instinct carries real risk here.”

Reviewed by 2 · Jul 18, 2026

Open the Sacubitril, Valsartan interaction page

One more smart check

Taking Quassia as Part of a Dietary Supplement Product? Check It for Interactions

We hold 172 real supplement products containing Quassia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Quassia. Your product may carry other ingredients that interact with Sacubitril, Valsartan too, on top of Quassia — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Quassia and Sacubitril, Valsartan Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Quassia
Top half

#473 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Sacubitril, Valsartan
Top 5%

#131 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Quassia

What is Quassia?

  • Loss of appetite
  • Digestive upset
  • Head lice (topical)
  • Intestinal worms/parasites
  • Bitter tonic

Quassia is a tropical wood known for its very bitter taste, traditionally used as a digestive bitter and as a folk remedy for parasites and head lice. Human evidence for these uses is limited, and high doses may irritate the stomach, so it should be used cautiously and avoided in pregnancy.

Read the full Quassia monograph & all interactions
Medication

About Valsartan and Sacubitril

What Is Valsartan and Sacubitril Used For?

Brand name: Entresto

Sacubitril and valsartan is used to reduce the risk of cardiovascular death and hospitalization for heart failure in adult patients with chronic heart failure. The benefit is most clearly seen in patients whose heart pumps with a lower-than-normal ejection fraction (the percentage of blood the heart pushes out with each beat).

It is also approved to treat symptomatic heart failure with reduced left ventricular function in children aged 1 year and older. In pediatric patients, it lowers a blood marker of heart stress (NT-proBNP) and is expected to improve heart outcomes.

See full Valsartan and Sacubitril drug information
Keep checking

Other Drugs & Quassia

Browse every other medication we’ve checked against Quassia — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
161Moderate
36Minor
2,632No known interaction
161 Moderate 36 Minor 2,632 No interaction
Moderate

161 interactions

Showing 60 of 161 moderate interactions — see all 161 on the Quassia page.

Minor

36 interactions

No interaction 2,632 drugs checked — show the list

We also checked Quassia against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,632 medications checked with no known interaction — see the full Quassia list.

See the full Quassia interactions page
See every supplement checked against Sacubitril, Valsartan, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Quassia monograph › Uses, safety, and every drug interaction in one place Sacubitril, Valsartan supplement interactions › Every supplement checked against Sacubitril, Valsartan, ranked by severity Valsartan and Sacubitril drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Quassia and Sacubitril, Valsartan Together: Common Questions

Can you take Quassia with Sacubitril, Valsartan?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Quassia and Sacubitril, Valsartan interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Sacubitril, Valsartan and Quassia?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.